Manager, Payment Variance Revenue Integrity at Aspirion

Alameda, California, United States -

Full Time

Start Date

Immediate

Expiry Date

06 Jul, 26

Salary

0.0

Posted On

07 Apr, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Revenue Cycle Management, Healthcare Billing, Medical Coding, Data Analysis, Auditing, Financial Acumen, SQL, EHR, EMR, Claims Handling, Client Relations, Project Management, Revenue Integrity, Charge Capture, Compliance, Communication

Industry

Hospitals and Health Care

Description

Description For over two decades, Aspirion has delivered market-leading revenue cycle services. We specialize in collecting challenging payments from third-party payers, focusing on complex denials, zero balance payment reviews, aged accounts receivables, motor vehicle accident, workers’ compensation, Veterans Affairs, and out-of-state Medicaid. At the core of our success is our highly valued team of over 1,400 teammates as reflected in one of our core guiding principles, “Our teammates are the foundation of our success.” United by a shared commitment to client excellence, we focus on achieving outstanding outcomes for our clients, aiming to consistently provide the highest revenue yield in the shortest possible time. We are committed to creating a results-oriented work environment that is both challenging and rewarding, fostering flexibility, and encouraging personal and professional growth. Joining Aspirion means becoming a part of an industry leading team, where you will have the opportunity to engage with innovative technology, collaborate with a diverse and talented team, and contribute to the success of our hospital and health system partners. Aspirion maintains a strong partnership with Linden Capital Partners, serving as our trusted private equity sponsor. We are seeking an engaged and driven Revenue Integrity Manager for our Payment Variance team. As a Revenue Integrity Manager you will work closely with your team on assigned project(s) to be a trusted point of contact for our clients and team members. The Revenue Integrity Manager will support the success of the Payment Variance department by optimizing hospital revenue by reviewing retrospective hospital billing for charge capture opportunities, identifying trends across payers and billing practices, enhancing charge capture processes, ensuring compliance with billing and coding regulations, and preventing revenue leakage. They act as a liaison between revenue cycle (zero balance teams) teams and hospital client data integrity teams to communicate necessary coding and billing updates. The ideal candidate for this position will have demonstrated experience in retrospective reviews billing and coding reviews, knowledge and comfort reviewing commercial payer, Medicare and Medicaid billing and coding guidelines and periodic changes. Experience managing multiple hospital clients and teams. Key Responsibilities · Revenue Leakage Prevention: Proactively identify and resolve charge capture opportunities and issues in revenue-producing departments, reducing denial rates. · Data Analysis & Auditing: Lead complex audits, analyze financial trends, and prepare methodologies for annual billing and coding changes. · Mentorship: Provide guidance and support to leaders and teammates as an informal leader. · Review contracts between hospitals and insurance carriers, model claims data, and identify lost revenue · Perform analysis on large data sets to identify underpayment and denial trends related to billing and coding · Conduct research on current laws and regulations pertaining to hospital reimbursement methodology · Contribute to client decks and weekly reports to track progress of project goals and present to leadership · Attend Privacy and Security Training as required by the HIPAA Awareness Program and comply with all guidelines, policies and procedures to assure sensitive or confidential information is protected in accordance with the HIPAA rules and regulations Requirements Requirements · Detail-oriented and organized with the ability to manage time effectively and prioritize competing tasks · Excellent communication skills both written and verbal · Basic to experienced knowledge of Excel · Effective documentation skills · Strong organizational skills · Possesses analytical capabilities and financial acumen · Must have private and dedicated workspace that ensures confidentiality · Understanding of health insurance, EHR’s, EMR’s, and claims handling Education and Experience · Undergraduate degree or internship in a healthcare related field preferred · Healthcare operations experience preferred · Understanding of auditing and reporting tools such as SQL · Presentation skills and client relations experience a plus · 5 + years of experience in Revenue Cycle or Healthcare Claims preferred

Responsibilities

The Revenue Integrity Manager optimizes hospital revenue by identifying charge capture opportunities and preventing revenue leakage through retrospective billing reviews. They also act as a liaison between internal teams and hospital clients to communicate necessary coding and billing updates.